Practice management

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Self-management–the RIM-CORECT Framework

Pillar Essentials Practical checkpoints
R–Registration HPCSA specialist registration (Form 19) current; annual renewal paid by 31 March. Keep electronic copy of HPCSA card in cloud vault; display original in rooms.
I–Income-protection Disability & dread-disease cover sized to ≥ 60 % after-tax earnings. Review every 3 years or at major career change.
M–Malpractice Professional indemnity (e.g. Aon/ EthiQal) ≥ R 10 million per claim—SASA recommendation. Extend tail cover for locums; disclose high-risk practice (cardiac, obstetrics).
C–Computerised systems Secure EMR, e-prescribing, cloud PACS; two-factor authentication; POPIA-compliant backup. Perform annual cyber-security drill.
O–Obligations (contracts) Written job plan covering hours, overtime, call roster, KPIs, leave & CPD time. Keep signed copy; review vs BCEA overtime limits.
R–Retirement Maximise tax-deductible RA (27.5 % of taxable income ≤ R 350 k). Target 15× final annual salary by age 65; invest via low-cost index options.
E–Education & CPD HPCSA: ≥ 60 CEUs/24 m with ≥ 10 ethics; SASA simulation & Also refresh ≤ 2 y. Use MyCPD app to store certificates.
C–Clinical & admin time-management Weekly template balancing theatre, clinic, teaching, research, QI and wellness; apply Eisenhower (urgent/important) matrix. Block 2 h each Friday for inbox & billing reconciliation.
T–Time-out / self-care Rosters respect SASA ≤ 80 h/6 w guideline; schedule exercise, family time, leave. Use fatigue-risk predictor & track sleep debt.

Professionalism–competency Matrix (adapted from GMC 2024 & SASA Code 2023)

Domain Element Details
1. Partnership Trust With patients and colleagues
Working Together Conflict resolution in the patient’s best interest
Good Communication Interand intra-disciplinary communication, including with the patient
Advocacy Avoiding patient risk and inappropriate treatments
2. Practice Caring When Treating Patients Respect dignity, modesty, manage anxiety; honour patient preferences
Promoting Patient Safety Recognize/minimize errors; in AEs: support colleagues, communicate with family, report errors non-judgmentally
Self Care Maintain physical and mental wellbeing; seek support during stressful periods
Practice Management Record-keeping, handovers, and transparent rosters
Confidentiality Data protection, consent management, responsible use of social media
Integrity Dependability, punctuality, and non-discrimination
Conflict of Interest Avoid research misconduct and professional bias
Competence Training and continuing medical education (CME)
3. Performance Reflective Practice Evaluate individual/team performance to identify improvement areas
Teaching and Training Actively participate in educating peers and trainees
Acting as Role Models Demonstrate professional behaviour and leadership
Domain Day-to-day behaviours
Expert Practise within competence; escalate early; prioritise patient safety.
Communicator Use SBAR for handover; verify understanding with teach-back.
Collaborator Lead WHO brief; respect diversity; delegate appropriately.
Manager/Leader Allocate theatre resources wisely; model civility; support QI projects.
Health advocate Promote peri-op smoking cessation; safeguard trainee wellbeing.
Scholar/Teacher Keep learning plan; publish/share audits; mentor juniors.
  • The HPCSA 2025 Ethical Guidelines emphasise dignity, fairness, honesty and patient-centred decision-making.

Minimising Medico-legal Exposure

  1. Write contemporaneous, legible electronic notes (retain ≥ 7 years / minors = age + 7).
  2. Follow SASA, HPCSA & local SOPs; document deviations with rationale.
  3. Obtain valid informed consent–procedure, risks, benefits, alternatives, interpreter if needed.
  4. Never coerce a patient into a single anaesthetic plan.
  5. Verify and record co-morbidities, meds, labs (incl. coagulation).
  6. Use only techniques you are trained & privileged for; record credentialing.
  7. Carry adequate malpractice cover; avoid vicarious liability through clear delegation.
  8. Engage in interdisciplinary consultation early when complications arise; disclose promptly (duty of candour).
  9. Institute quality-assurance audits & incident reviews; act on findings.

HPCSA Social-media & Confidentiality Essentials

From Booklet 16 (2019, reaffirmed 2025)

  • Share patient data only with care team, with consent, or where mandated by law / overriding public interest.
  • Written consent required even if patient not identifiable; for < 12 y obtain guardian consent and child assent.
  • Post the minimum necessary; watermark educational images “© with permission”.
  • Warn recipients content is confidential; remove identifiers from metadata.
  • Remember viral spread risk; duty of confidentiality survives the patient’s death.
  • Maintain separate professional and personal profiles; never discuss cases on WhatsApp groups lacking end-to-end encryption.

Links

References:

  1. Gelb, Adrian W. MBChB, FRCPC*; Morriss, Wayne W. MBChB, FANZCA†; Johnson, Walter MD‡; Merry, Alan F. MBChB, FANZCA, FFPMANZCA, FRCA§. World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia. Anesthesia & Analgesia 126(6):p 2047-2055, June 2018. | DOI: 10.1213/And.0000000000002927
  2. Apfelbaum, J. L. and Connis, R. T. (2019). The american society of anesthesiologists practice parameter methodology. Anesthesiology, 130(3), 367-384. https://doi.org/10.1097/aln.0000000000002551
  3. O’Shaughnessy, S. M., Lee, J. Y., Rong, L. Q., Rahouma, M., Wright, D., Demetres, M., … & Kachulis, B. (2022). Quality of recent clinical practice guidelines in anaesthesia publications using the appraisal of guidelines for research and evaluation ii instrument. British Journal of Anaesthesia, 128(4), 655-663. https://doi.org/10.1016/j.bja.2021.11.037
  4. Health Professions Council of South Africa. Booklet 16: Ethical Guidelines on Social Media (2019, reaffirmed 2025). hpcsa-blogs.co.za
  5. HPCSA. New and Updated Ethical Guidelines (Press release, 13 Jun 2025). hpcsa-blogs.co.za
  6. South African Society of Anaesthesiologists. Member Code of Conduct for Anaesthesia Professionals (2023). sasaweb.com
  7. General Medical Council. Good Medical Practice (2024 update). gmc-uk.org
  8. SASA. Practice Guidelines 2022–Professionalism & CPD (Chapters 1 & 8). sasaweb.com

Summaries:

Copyright
© 2025 Francois Uys. All Rights Reserved.

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